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Radioactive Materials Branch
Forms & Publications

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This section of the website offers a "one stop" look at most of the forms and publications on the Radioactive Materials Section portion of the website.  If you have any questions on completing these forms, please contact a member of the Radioactive Materials Branch Staff for assistance.  Any new or updated forms or publications will have the (Information on ordering Regulations) symbol next to them.

NOTE:   Most of the PDF () forms on this page are "editable."  You can save the form to your local disk and enter information into the form.  However, you WILL NOT be able to save the information typed into the form.  This is a function of Adobe Reader, and not a security setting from DRP.  With the Word97 () Documents, you will be able to save the form, make entries and save those entries.


Description of Form / Publication File Format(s)
Application for Radioactive Materials License
Application for Accelerator License
Application for Amendment Form
Preceptor Statement (Supplement A) for Medical Licenses
Medical Event Reporting Form  
Dose to an Embryo/Fetus or Nursing Child Reporting Form  
Certificate of Disposition of Radioactive Materials (for license termination or decommissioning)
Financial Assurance Worksheet (UNDER CONSTRUCTION )
Radiographic and Reciprocity Location report
Memorandum to All Licensees §(see below)
Guidance on Change of Control of Ownership
Occupational Dose Record for a Monitoring Period
Guidance on Adding Board Certified Physician Authorized Users
Notice to Employees (PDF ONLY - 8˝" x 14" landscape format)
Notice to Employees (EN ESPAŃOL)  (PDF ONLY - 8˝" x 14" landscape format)
New ! 2015 Low Level Radioactive Waste Survey Form    


NRC Regulatory Guide 8.39 "Release of Patients Administered Radioactive Materials"  


DOT - SP 11406 Exemption Instructions
DOT - SP 11406 Form  
DOT- SP 10656 Exemption Instructions  
DOT -SP 10656 Form
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Last Modified :10 October 2016
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